Review of facial muscle spasms

Facial muscle spasms, which are rare in adults, present a particularly difficult entity for the optometrist to recognise. The condition may not even manifest itself at an eye examination and the optometrist may have to rely on subjective symptoms to assist in the recognition of the condition. It is important to diagnose the condition correctly as specific and effective treatment is available.     

Lymphangiosarcoma in late-onset hereditary lymphedema: Case report and nosological implications

Hereditary lymphedemas that are not associated with other malformations usually affect the lower limbs and are inherited in an autosomal dominant fashion. These non-syndromic hereditary lymphedemas are categorized by their age of onset, being either congenital (Milroy disease) or having an onset in childhood or around puberty (Meige disease). We describe a family in which three individuals in three generations had unusually late onset of lym-phedema in their mid-twenties or thirties. The proband additionally developed a very rare lymphangiosarcoma. This tumor, usually associated with post-mastectomy lym-phedema, has not been described in late-onset hereditary lymphedema. Because of an unusually high incidence of multiple primary tumors in association with lymphangiosarcoma in the literature (approximately 10%) and the proband's own familial cancer background, we speculate that an inherited predisposition to malignancy may underlie the development of lymphedema-associated lymphangiosarcoma. © 1995 Wiley-Liss, Inc.     

压力调节容量控制通气对肺损伤犬血流动力学、呼吸力学和呼吸功能的影响

目的 探讨压力调节容量控制(PRVC)通气模式对健康及急性肺损伤(ALI)模型犬的血流动力学、呼吸力学和呼吸功能的影响。方法 PRVC和间歇正压通气(IPPV)两种通气模式在呼气末压为0、0．5、1．0和1．5kPa时，分别测定健康犬及油酸诱发ALI犬的血流动力学、呼吸力学及血气参数。结果 健康犬PRVC较IPPV模式下除了在PEEP为0．5kPa时，气道峰压(PIP)、肺动态顺应性(Cdyn)和肺血管阻力(PVR)的影响差异有显著性，对血流动力学、呼吸力学及呼吸功能的影响差异均无显著性。ALI犬PRVC较IPPV模式下各PEEP水平的PIP、平均气道压(mPaw)、Cdyn、动脉血氧分压[pa(O2)]和氧耗(VO2)的影响均有显著意义，但两种通气模式对血流动力学的影响差异无显著性。结论 与IPPV相比，PRVC通气模式能降低PIP，增加Cdyn和提高pa(O2)，两模式对血流动力学的影响差异无显著性，PRVC更适用于ALI／ARDS的治疗。     

Asynchronous blepharospasm, facial and cervical dystonia, and bilateral asynchronous hemifacial spasm.

We present a patient with a facial movement disorder that has characteristics of both blepharospasm and bilateral asynchronous hemifacial spasm. Because of the increased incidence of blepharospasm in patients with hemifacial spasm, our patient's clinical presentation is probably not a chance occurrence, but rather a manifestation of some predisposition for these two movement disorders. This unusual constellation of signs and symptoms challenges the current diagnostic criteria and suggests that some of these facial movement disorders may lie on a spectrum, rather than represent distinct entities.     

Microvascular decompression for hemifacial spasm: postoperative neurologic follow-up and evaluation of life quality

Microvascular decompression (MVD) is an effective and safe treatment in hemifacial spasm (HFS). Postoperative evaluations are usually made by neurosurgeons. Follow-up studies performed by neurologists and postoperative quality of life (QoL) investigations are lacking. All 25 HFS patients operated with MVD in our centre between 2000 and 2004 were evaluated with the recently validated HFS-7 scheme, extended with the item 'sleep disturbance due to HFS' (HFS-8). The patients underwent a careful neurological examination median 3 years after the operation. The evaluation focused on clinical aspects, changes in blood pressure and time until observable effect of MVD. The evaluation of HFS-7 questionnaire and the extended form (HFS-8) showed significant improvement in QoL after MVD. Neurological outcome was in almost all cases excellent or good. Eleven (44%) patients had no neurological deficits at all. Only one patient had serious complications with ipsilateral facial palsy, deafness, balance problems and vertigo. The other patients had minor neurological findings or symptoms. Eighteen (72%) patients experienced early effect within 3 months after MVD; seven (28%) patients had late effect between 6 and 14 months. Median age of the patients with late effect (62.6 years) was significantly higher than in those with early effect (52.7 years).     

面肌痉挛显微血管减压术的诱发肌电图监测和评估

目的:探讨面神经诱发肌电图在显微血管减压(MVD)术中、术后对面肌痉挛治疗效果的监测和评估。方法:对26例典型面肌痉挛病人、探讨在MVD术前、术中、术后,经皮刺激痉挛侧(手术侧)面神经下颌缘支,记录诱发同侧眼轮匝肌肌电位(MD-OC反应)变化,并以正常侧作对照检查。结果:26例术前均记录到痉挛侧MD-OC反应,在术中操作不同阶段,21例均见MD-OC反应消失。术后1周～3个月随访复查21例中,12例痉挛完全消失,MD-OC反应不复存在,9例症状明显或部分减轻,但有4例再记录到MD-OC反应。另5例术中,术后均记录到MD-OC反应,症状未有改善。结论:面神经诱发肌电图运用于MVD术中监测和预后判断,可改善和提高面肌痉挛的治愈率。     

肺性脑病与多器官功能障碍临床分析

目的：分析43例肺性脑病与多器官功能障碍的关系，以便早期采取预见性防治措施。方法：把43例肺性脑病时伴发的功能障碍器官个数与死亡率的关系及酸碱、电解质测定进行统计列表分析，结果：肺性脑病100％并发器官功能障碍，最常受损器官：肺、心、脑、肝或肾，受损器官数目越多，病情越严重，肺性脑病时，呼酸代酸，低钠，低氯血症明显增多。结论：肺性脑病100％伴发多器官功能障碍，随功能障碍器官数目的增加，死亡率亦增加，酸碱失衡及电解质紊乱与多器官功能障碍有关。     

Oculoauriculovertebral anomaly: Segregation analysis

Seventy-four families of probands with oculoauriculovertebral anomaly were evaluated, including 116 parents and 195 off-spring. Relatives were examined to identify ear malformations, mandibular anomalies, and other craniofacial abnormalities. For segregation analysis using POINTER, selection of the sample was consistent with single as-certainment. Different population liabilities were used for probands and relatives, because affection was narrowly defined for probands and broadly defined for relatives. The hypothesis of no genetic transmission was rejected. The evidence favored autosomal dominant inheritance; recessive and polygenic models were not distinguishable. © 1992 Wiley-Liss, Inc.     

面肌痉挛病因学机制的实验研究

目的 建立面肌痉挛动物（ＨＦＳ）模型,探讨其病因及发病机理。方法 ２８只新西兰大白兔随机分为模型组和对照组,采用颞浅动脉压人为脱髓鞘变的外周面神经主干的方法复制ＨＦＳ动物模型,术后３、６周分别通过电生理技术透发异常肌反应（ＡＭＲ）。结果 术后３周各组动物均未诱发ＡＭＲ,术后６周在模型组动物上诱发ＡＭＲ,而对照组动物仍无ＡＭＲ。结论 动脉压迫面神经是ＨＦＳ的发病原因,建立合适的ＨＦＳ动物模型为进一步